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Pharm 2 - Urogenital 3

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martinezdvm's version from 2016-03-01 00:24

Prostatic Dz in Dogs

Question Answer
What is the 1⁰ mediator of BENIGN PROSTATIC HYPERPLASIA in dogs?Overproduction of Dihydrotestosterone (DHT)
What are the 2 Txs for benign prostatic hyperplasia?(1) Finasteride (synthetic steroid type-II 5α-reductase inhibitor: Block the pathway for conversion of testosterone into DHT)
(2) Sx (castration) (finas off those balls by cutting them off)
What is happening in acute prostatitis & how do you tx it?Ascending bacterial infxn caused by E. coli, Mycoplasma, Staphylococcus, Streptococcus, Klebsiella etc → Tx w/ CIDAL abx!
If you have an acute prostatitis, why do you care about/what is the pH of the prostate?The prostate pH is < blood pH = acidic tissue. Since acute prostatitis is usually due to a bact infxn, you want to pick an abx which will be attracted to the acidic pH of the prostate/be ionized once it gets into prostate so it wont leave - so you want basic abx, such as Erythromycin, Trimethoprim (ERY 1 TRIn to be a basic bitch) & LIPOPHILIC drugs such as Fluoroquinolones, Chloramphenicol, TMPS (I want FATTY food & a CHLORinated hot tub when I need to be using TaMPonS)
Difference btwn acute & chronic prostatitis?Acute is usually multiple bacteria causing a problem
Chronic is usually one
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Dzs of the bladder

Question Answer
What is a bacterial infxn of the bladder called?Cystitis
Do you want a static or a cidal abx for treating cystitis?CIDAL, bc static just stops them & then the phagocytes are supposed to take over, but in the bladder its not super easy for phagocytes to get into
What would symptomatic (symptom is bladder contractions) Tx of cystitis entail? What kinda drugs would you use & which type (structure) is preferred?Inhibition of bladder contractions (Oxybutynin - Propanthelin). Want the drugs w/ quaternary structures, bc these cant get into the brain & cause CNS SFx like the tertiary do (bc they are much bigger)
What is "urge incontinence" usually caused by?Cystitis & bladder stones
3 main causes of incontinence?(1) Urge incontinence (cystitis & bladder stones)
(2) Reactive/spastic bladder
(3) In the bitch urethral sphincter mechanism incompetence
Incontinence in the bitch is usually due to what?Urethral sphincter mechanism incompetence (↓ Estrogen → ↓ α receptors → less contraction)
Which drugs tx the negative symptoms of cystitis, specifically, the bladder contractions?Oxybutynin, Propanthelin (oxy will relax your bladder for sure & so will huffing propane) (wont mix up w/ drugs for hypertonic urethra bc oxys are REALLY strong & the bladder is WAY bigger) (bladder contractions are not phen, so no phen in these drugs)
Explain how innervation differs btwn the storage & voiding phases of the bladder(Storage) SYMPATHETIC innervation of the bladder (relaxation) & urethra (contraction). (Voiding) controlled by voluntary control centers & mediated by spinal pathways & the pelvic nerve (parasympathetic innervation to the bladder & inhibition of sympathetic pathways)
Bladder contraction & opening of the internal sphincter is controlled by what nerve?Pelvic nerve
What does the pelvic nerve do?Bladder contraction & opening of the internal sphincter (Parasympathetic)
Contraction of internal sphincter & relaxation of detrusor muscle is controlled by what nerve?Hypogastric
What does the hypogastric nerve do?Contraction of internal sphincter & relaxation of detrusor muscle (sympathetic)
What are the 2 types of receptors which control the bladder? Which nerve effects which receptor for what result?(1) M3 receptor → pelvic nerve → contract bladder ("M3 for pee")
(2) β2 receptor → hypogastric nerve → relaxation of bladder (remember that 2 is on the inside & pushes out = relaxation. so β-2) (BM for bladder movement)
What is the receptor in the internal urethral sphincter? What nerve effects it, to do what?α-1 receptor → hypogastric nn → contraction of internal sphincter (the internal sphincter is A #1 defense against pissing yourself & then vomiting (gastric) from the embarrassment)
What is the receptor of the external urethral sphincter? What nerve effects it, to do what?Nicotinic receptor → pudendal nerve (SOMATIC nerve) → contraction of external sphincter (nicotine will make you tense up & not pu)
If you have a hypocontractile bladder, what do you want to do?Stimulate the Parasympathetic system
If you have a hypercontractile bladder, what do you do? Drugs?Tx underlying cause & then you can use parasympatholytic drugs (Oxybutynin, Propantheline, TCA Imipramine) (remember, take strong oxys to relax bladder & huff propane to relax too & then the TCA (TSA) Will bust you but you can say IM gonna pee!)
Why do Estrogens help a hypOtonic urethra (sphincter incontinence)Estrogen causes sensitization & up-regulation of α-receptors
HypOtonic urethra can be Txed w/ what 2 types of things? (Name drugs)(1) Estrogens (Diethylstilbestrol, Stilbestrol)
(2) α-adrenergic agonists (Phenylpropanolamine)
α-adrenergic agonists would be used to tx what? What is the drug in this category?Tx hypOtonic urethra. Phenylpropanolamine. (Also no phen when you're always peeing. remember that you can have more phen by PROPing the urethral door closed) (There is just prop just hypercontractile bladder (no phen there). Then there is phen-oxy for hypertonic urethra bc oxy to relax & then you can see so you can have phen again. Then THIS 1 is phen-prop bc its not phen when you have to prop the urethral door closed)
What would you use Estrogens for & what are the drugs in this category?Tx hypOtonic urethra. Diethylstilbestrol, Stilbestrol
What are the 2 categories of drugs youd use to tx Hypertonic urethra?(1) α-adrenergic antagonists (Phenoxybenzamine, Prazosine)
(2) Striated muscle relaxants (Diazepam, Dantrolene) (bc 2 sphincters that are diff types of mm, so need 2 diff categories)
What are striated muscle relaxants used for & what are the drugs in this category?Tx hypERtonic urethra. Diazepam, Dantrolene (dan takes Diazepam to relax his tense urethra in his dick)
What are α-adrenergic antagonists used for & what are the drugs in this category?Tx hypERtonic urethra. Phenoxybenzamine, Prazosine (A PP. you need to do it! It’s not phen when you cant pee, you praz to jesus that you can)
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Check yo'self before you wreck yo'self → Specific dz drugs

Question Answer
What is the RAAS? Fxn? If you have kidney dz, what do you wanna do w/ the RAAS?Renin-Angiotensin-Aldosterone System (hormone system that regulates BP & H2O (fluid) balance. Angiotensin causes vasoconstriction & Aldosterone causes H2O & Na retention) If you have kidney dz, then, you wanna INHIBIT it, bc it will then REDUCE the BP & there will be LESS retention of H2O & salt, which puts less burden on the kidneys
What is Telmisartan?Angiotensin receptor blocker
What is Losartan?Angiotensin receptor blockers
What is Finasteride?Tx prostatic hyperplasia (block the pathway for conversion of testosterone into Dihydrotestosterone (DHT) )
What are the kind of drugs you want to Tx prostatitis w/? (Relating to their PKs)Basic (Erythromycin, Trimethoprim) & LIPOPHILIC (Fluoroquinolones, Chloramphenicol, TMPS)
For cystitis – Should ABx be static or cidal?Cidal
What would you use Oxybutynin & Propanthelin for?↓ bladder contractions in cystitis. (Note: Want quaternary structure, not tertiary, bc tertiary can cause CNS SFx)
Which drugs to tx cystitis' symptoms of bladder contractions?Oxybutynin, Propanthelin
What does the pelvic nerve do?Bladder contraction & opening of the internal sphincter (Parasympathetic)
What does the hypogastric nerve do?Contraction of internal sphincter & relaxation of detrusor muscle (sympathetic)
Where is a M3 receptor, what is it doing, what is it stimulated by?In bladder, to contract it, via pelvic nerve (parasymp)
Where is a β2 receptor, what is it doing, what is it stimulated by?In bladder, to relax it, hypogastric nerve (symp)
Where is a α-1 receptor, what is it doing, what is it stimulated by?Internal urethral sphincter, to constrict it, hypOgastric n (symp)
Where is a nicotinic receptor, what is it doing, what is it stimulated by?External urethral sphincter, to constrict it, pudendal nerve (SOMATIC)
Oxybutynin is used for?Parasympatholytic used for hypERcontractile bladder
Propantheline is used for?Parasympatholytic used for hypERcontractile bladder
TCA is used for?Parasympatholytic used for hypERcontractile bladder
Imipramine is used for?Parasympatholytic used for hypERcontractile bladder
Phenylpropanolamine is used for?α-adrenergic agonist used to Tx hypOtonic urethra
Diethylstilbestrol & Stilbestrol used for?Are Estrogens, used to Tx a hypOtonic urethra
Diazepam is used for?A striated mm relaxant used for treating a hypERtonic urethra
Dantrolene is used for?A striated mm relaxant used for treating a hypERtonic urethra
Phenoxybenzamine is used for?α-adrenergic antagonist used for treating a hypERtonic urethra
Prazosine is used for?α-adrenergic antagonist used for treating a hypERtonic urethra
For treating cystitis w/ abx...when would the MIC not matter?Wouldnt matter if the abx is metabolized into an inactive compound before it is excreted.....bc when it gets to the bladder, it's inactive & wont do anything
If you get a sensitivity test, what kinda MIC do you want?Low!!! Means you need less drug to do the same job which is good
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